Our data revealed a high prevalence of ankylosing spondylitis, axial spondyloarthritis, and inflammatory back pain 20 years after the IBD diagnosis. HLA-B27 but not NOD-2 was a predisposing factor for the inflammatory back disorders in IBD patients. Axial spondyloarthritis was associated with a more chronic active IBD disease course.
Background:Participation in cancer screening programmes might cause worries in the population outweighting the benefits of reduced mortality. The present study aimed to investigate possible psychological harm of participation in a colorectal cancer (CRC) screening pilot in Norway.Methods:In a prospective, randomised trial participants (aged 50–74 years) were invited to either flexible sigmoidoscopy (FS) screening, faecal immunochemical test (FIT), or no screening (the control group; 1 : 1: 1). Three thousand two hundred and thirteen screening participants (42% of screened individuals) completed the Hospital Anxiety and Depression Scale questionnaire as well as the SF-12—a health-related quality of life (HRQOL) questionnaire when invited to screening and when receiving the screening result. A control group was invited to complete the questionnaires only. Two thousand six hundred and eighteen control participants (35% of invited individuals) completed the questionnaire.Results:A positive screening result did not increase participants' level of anxiety or depression, or decrease participants' level of HRQOL. Participants who received a negative result reported decreased anxiety and improvement on some HRQOL dimensions. However, no change was considered to be of clinical relevance.Conclusion:The current study showed no clinically relevant psychological harm of receiving a positive CRC screening result or of participating in FS or FIT screening, in a Norwegian population.
Ongoing joint pain and back pain were associated with reduced quality of life and fatigue in IBD patients after 20 years of disease, whereas spondyloarthritis without ongoing joint symptoms did not have a negative impact on these patient-reported outcomes.
Abstracts of the 12 th Congress of ECCO -European Crohn's and Colitis Organisation S153interested to better understand the effect of IBD on pregnancy outcomes. Methods: Between 2011 and 2015, a total of 39 pregnant patients with IBD were reviewed. Sixteen had Crohn's disease (CD) and 23 had ulcerative colitis (UC). We retrospectively evaluated the 41 pregnancy outcomes in these 39 patients. In the CD cases, active disease was defined as CD activity index (CDAI) ≥150), while in the UC cases, active disease was defined as clinical activity index (CAI) ≥4. The pregnancy and neonatal complications including spontaneous abortion, preterm delivery (<37 weeks), caesarean section, low birth weight (<2500g) and congenital abnormality were determined. Results: The mean age was 33.5±4.2 years in CD patients and 32.7±5.2 years in UC patients. For most patients, IBD was inactive prior to pregnancy (84%, n=33). Elemental diet (n=9 cases) and anti-tumour necrosis factor-α biologics (n=10) were the most commons drugs used during pregnancy in CD patients, while mesalamine (n=22) was the most common drug in UC patients. Flare up rate during pregnancy was higher in UC patients than in CD (62.5% vs 29.4%). Most patients relapsed in the first pregnancy trimester (28.5%) and puerperal period (60%). The rate of preterm delivery (12.2%), low birth weight (22.0%) and caesarean section (31.7%) were not significantly different from non-IBD controls (n=394; 28.4%, 32.3%, 46.4% respectively). However, the rate of congenital abnormality was higher in IBD patients than in non-IBD (7.3% vs 0.2%). The rate of neonatal and pregnancy complications was significantly higher during active disease than during quiescent period (p<0.05).
Conclusions:We found that IBD flare ups had occurred particularly in the first pregnancy trimester and puerperal period. Flare up rate was higher in UC patients than in CD patients. Accordingly, IBD patients, particularly UC patients should be diligently monitored in the first pregnancy trimester and puerperal period. Likewise, in this study the prevalence of congenital abnormality was higher in IBD patients than in non-IBD, but we did not investigate the risk factors for congenital abnormality in the IBD clinical setting.
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